title: Adjustment and vocational satisfaction of patients treated during childhood or adolescence for acute lymphoblastic leukemia.
abstract: This investigation evaluated the psychosocial consequences of the diagnosis and treatment of acute lymphoblastic leukemia (ALL) on the long-term adjustment of a sample of 46 patients less than 20 years of age at diagnosis (mean age: 7.46 years). Subjects were followed up for an average of 15.4 years after diagnosis and were a mean of 22.87 years old at assessment. A sample of Hodgkin's disease and non-Hodgkin's lymphoma survivors served as a comparison group. Patients completed standardized measures of well-being, stress reaction, vocational satisfaction, and a questionnaire assessing defensiveness regarding their history of cancer treatment, experienced job discrimination, and social involvement. Overall, the subjects appeared to be well-adjusted; female subjects, however, exhibited an increased tendency to experience anxiety in stressful situations. Vocational discrimination did not appear to be a significant problem for this group of survivors, and subjects exhibited levels of vocational satisfaction that did not differ from population norms. Greater defensiveness regarding a history of cancer treatment was associated with lower levels of well-being and heightened stress reaction. Survivors who received CNS prophylaxis that included cranial irradiation had lower well-being scores than did those survivors receiving only intrathecal methotrexate.
authors.affiliation: Department of Psychology, Roswell Park Cancer Institute, Buffalo, New York 14263.
authors.forename: M A
authors.initials: MA
authors.lastname: Zevon
authors.forename: N A
authors.initials: NA
authors.lastname: Neubauer
authors.forename: D M
authors.initials: DM
authors.lastname: Green
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003674:Defense Mechanisms; D005190:Family / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008393:Marriage / Q000523:psychology; D010555:Personality Inventory; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000523:psychology* / Q000628:therapy; D012917:Social Adjustment; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires